Ms Youn Park1, Mrs Natividad Miles1, Mrs Carmen Moroney CNS Moroney1, Mr Thanh Bui1, Mr Shanes Morgan1, Dr John Saunders1, Dr Paul Snelling1
1Royal Prince Alfred Hospital, Sydney, Australia
Background: Pseudomonas exit site infection (ESI) often results in catheter removal despite intensive antibiotic treatment. Our peritoneal dialysis (PD) unit experienced repeated episodes of pseudomonas ESI. We report pseudomonas infection rates of in PD patients (pts) before and after using 2.5% acetic acid dressing (AAD) for infected exit site with Pseudomonas.
Aim: To analyse the effectiveness of 2.5% acetic acid use for infected Pseudomonas ESIs
Methods: This observational Cohort study analysed pseudomonas ESI episodes between 2017 and 2019. We compared three groups with Pseudomonas ESIs using different antiseptic agents. Group 1 – Standard dressing (SD) only, Group 2-SD first and later change to AAD, Group 3- AAD only. All patients received standard oral antibiotics as our unit ESI policy. There were 18 patients with follow-up 20.9 patient years; 10 pts in Group 1 for 8.9 years, 3pts in Group 2 for 7.3 years (SD 3.5 years: AAD 3.8 years) and 5pts in Group 3 for 4.6 years.
Results: 28 Pseudomonas ESIs developed in 18 pts; 6 patients had 1-3 repeated Pseudomonas ESIs. Group 1 developed 5 repeated Pseudomonas ESIs in 4pts after initial Pseudomonas ESI, Group 2 developed 5 repeated ESIs in 3pts during the SD period. No repeated pseudomonas ESIs were recorded in Group 2 after AAD and no repeat ESI occurred in Group 3.
Conclusion: Repeated Pseudomonas ESI rates can be reduced using 2.5% acetic acid for chronic ES dressing. Acetic acid PD dressing use to eradicate Pseudomonas ESIs merits further investigation.
Youn Park has more than 35 years of renal experience and now works as a Home Therapies Clinical Nurse Consultant at Royal Prince Alfred Hospital and Concord Repatriation General Hospital, Sydney.